Meta-analysis of stroke after transradial versus transfemoral artery catheterization

Vishal G. Patel, Kimberly M. Brayton, Dharam J. Kumbhani, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Transradial (TR) catheterization is gaining popularity due to its association with lower bleeding and access site complications, improved patient comfort, and lower costs compared to transfemoral (TF) catheterization; however, there is concern that TR catheterization may be associated with an increased risk of neurological complications. New randomized data has emerged since the publication of the last meta-analysis evaluating the risk of stroke between TR and TF catheterization in 2009. Methods We conducted a meta-analysis of randomized studies published until 2013 reporting risk of stroke in TR vs. TF catheterization. Results Data from 11,273 patients in 13 studies were collated. The majority of patients were men, and 8987 (79.7%) were enrolled in acute coronary syndrome trials. Very few patients had a history of prior coronary artery bypass grafting, and approximately 2/3 of patients underwent percutaneous coronary intervention. Stroke occurred in 25 of 5659 patients in the TR group, vs. 24 of 5614 patients in the TF group. There was no difference in stroke rates between the TR and TF groups (risk difference 0.00%, 95% confidence interval - 0.29%-0.25%, p = 0.88). Conclusions TR catheterization is not associated with a significant increase in stroke compared to TF catheterization.

Original languageEnglish (US)
Pages (from-to)5234-5238
Number of pages5
JournalInternational Journal of Cardiology
Volume168
Issue number6
DOIs
StatePublished - Oct 15 2013

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Catheterization
Meta-Analysis
Arteries
Stroke
Percutaneous Coronary Intervention
Acute Coronary Syndrome
Coronary Artery Bypass
Publications
Confidence Intervals
Hemorrhage
Costs and Cost Analysis

Keywords

  • Catheterization
  • Stroke
  • Transradial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Meta-analysis of stroke after transradial versus transfemoral artery catheterization. / Patel, Vishal G.; Brayton, Kimberly M.; Kumbhani, Dharam J.; Banerjee, Subhash; Brilakis, Emmanouil S.

In: International Journal of Cardiology, Vol. 168, No. 6, 15.10.2013, p. 5234-5238.

Research output: Contribution to journalArticle

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abstract = "Background Transradial (TR) catheterization is gaining popularity due to its association with lower bleeding and access site complications, improved patient comfort, and lower costs compared to transfemoral (TF) catheterization; however, there is concern that TR catheterization may be associated with an increased risk of neurological complications. New randomized data has emerged since the publication of the last meta-analysis evaluating the risk of stroke between TR and TF catheterization in 2009. Methods We conducted a meta-analysis of randomized studies published until 2013 reporting risk of stroke in TR vs. TF catheterization. Results Data from 11,273 patients in 13 studies were collated. The majority of patients were men, and 8987 (79.7{\%}) were enrolled in acute coronary syndrome trials. Very few patients had a history of prior coronary artery bypass grafting, and approximately 2/3 of patients underwent percutaneous coronary intervention. Stroke occurred in 25 of 5659 patients in the TR group, vs. 24 of 5614 patients in the TF group. There was no difference in stroke rates between the TR and TF groups (risk difference 0.00{\%}, 95{\%} confidence interval - 0.29{\%}-0.25{\%}, p = 0.88). Conclusions TR catheterization is not associated with a significant increase in stroke compared to TF catheterization.",
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AU - Brilakis, Emmanouil S.

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